Men: good health and high mortality; sex differences in health and aging

Abstract

This review provides data documenting sex differences in health and survival with a focus on the Nordic countries. There is a remarkable discrepancy between the health and survival of men versus women: men are physically stronger and have fewer disabilities, but still males have substantially higher mortality at all ages compared to females, the so called male-female health-survival paradox. A number of explanations for the paradox have been proposed that are rooted in biological, social, and psychological interpretations. The paradox is likely to be due to multiple causes including fundamental biological differences between the sexes such as genetic factors, immune system responses, hormones and disease patterns. Behavioral differences such as risk taking and reluctance to seek and comply with medical treatment are also likely to play a role. Another consideration is that part of the difference could be due to methodological challenges in surveys such as selective non-participation and underreporting of health problems by men in surveys. The Nordic countries provide a unique opportunity for such studies considering a good quality of data in their national health registers comprising the total population and a long tradition for surveys with high participation rates.